%0 Case Reports
%T Multi-System Complications after Intravenous Cocaine Abuse.
%A Petkovska L
%A Chibishev A
%A Stevcevska A
%A Smokovski I
%A Petkovski D
%A Antova E
%J Open Access Maced J Med Sci
%V 5
%N 2
%D Apr 2017 15
%M 28507634
暂无%R 10.3889/oamjms.2017.046
%X <B>BACKGROUND: </B>Use and abuse of cocaine are associated with numerous adverse effects, independent of the route of administration. More severe conditions of poisoning, however, are observed after cocaine intravenous administration.<BR><B>OBJECTIVE: </B>We present a case of severe poisoning after violent intravenous injection of cocaine, but with a good outcome.<BR><B>METHODS: </B>Cocaine was intravenously (i.v.) administered in 16-years old female patient as a homicide attempt. Shortly after that, patient experienced series of generalised tonic-clonic seizures, was highly febrile (40°C), somnolent, agitated, presenting with tachycardia, tachypnea and with increased blood pressure 150/90 mmHg. Neurologic status, lumbar puncture and computerised tomography (CT) of the brain were without remarks. Electroencephalogram (EEG) was characterised with signs of diffuse encephalopathy, and acid-base analyses resulted in metabolic acidosis. Urine screening revealed the presence of cocaine and benzodiazepines. The patient presented with signs of the hepatic lesion, acute renal insufficiency (ARI), and increased D-dimers resulting from activated fibrinolysis. The patient was discharged in stable general condition after being hospitalised for 23 days.<BR><B>CONCLUSIONS: </B>Intravenous abuse of cocaine results in overdose and serous multi-system complications requiring multidisciplinary diagnostic and intensive therapeutic approach.